2018 Section 5 - Rhinology and Allergic Disorders
Avoidance after Early Peanut Consumption
Stayed allergic Stayed tolerant
Became allergic No longer allergic
A Peanut-Avoidance Group
B Peanut-Consumption Group
(N=46)
(N=202)
(N=3)
(N=4)
(N=1)
(N=186)
(N=3)
(N=0)
)
2 0 1
2 0 1
10
−1 −2
−1 −2
12
12 30
12 30
12 30 60
72
30 60
72
60 72
60
72
12 30
12
12 30 60
72
30
60
72
60
72
30 60
72
Ara h2–Specific IgE (kU/liter, log 4 to <11
4 to <11
4 to <11
4 to <11
4 to <11 12
4 to <11
4 to <11
4 to <11
)
2 3 0 1
2 3 0 1
10
−1 −2
−1 −2
12 30 60
12 30
12 30 60
72
30
60
72
72
60 72
Peanut-Specific IgE (kU/liter, log 4 to <11
12
12
12 30
12 30 60
72
30 60
72
30
60 72
60
72
4 to <11
4 to <11 12
4 to <11
4 to <11
4 to <11
4 to <11
4 to <11
20 10 15
20 10 15
5 0
5 0
Peanut Wheal (mm)
12 30 60
12 30
12 30 60
72
30
60
72
72
60 72
12 30 60 72
12 30 60
12
12 30 60
72
72
30 60 72
4 to <11
4 to <11 12
4 to <11
4 to <11
4 to <11
4 to <11
4 to <11
4 to <11
)
4.0 3.5 2.5 3.0 2.0 1.5
4.0 3.5 2.5 3.0 2.0 1.5
10
12
12 30 60
12 30 60
72
30 60 72
72
12
12
12
12 30 60
72
30 60
72
30
60
72
30
60 72
Peanut-Specific IgG4 (µg/liter, log 4 to <11
4 to <11
4 to <11 12 30 60 72
4 to <11
4 to <11
4 to <11
4 to <11
4 to <11
−2 0 2 4
−2 0 2 4
)
10
(log
12 30 60 72
12 30
12 30 60
72
30 60
72
60
72
12 30
12 30
12 30 60
72
30 60 72
60
72
60 72
4 to <11 12
4 to <11
4 to <11
4 to <11
4 to <11 12
4 to <11
4 to <11
4 to <11
Age at Visit (mo)
Age at Visit (mo)
Peanut-Specific IgG4:IgE Ratio
Figure 3. Immunologic Outcomes According to Differing or Stable Allergy Status between Months 60 and 72. Participants were categorized as “stayed allergic,” “stayed tolerant,” “became allergic,” or “no longer allergic.” Shown are the Ara h2– specific IgE antibody levels, peanut-specific IgE level, wheal size on skin-prick testing for peanut, peanut-specific IgG4 level, and IgG4:IgE ratios at the five assessments during the primary trial and the follow-up study. Data are shown only for participants who met the per- protocol criteria in both the primary trial and the follow-up study. At month 72, a total of 46 participants in the peanut-avoidance group and 1 in the peanut-consumption group were determined by the investigators to be still allergic, 202 in the peanut-avoidance group and 186 in the peanut-consumption group were still not allergic, 3 in the peanut-avoidance group and 3 in the peanut-consumption group became allergic, and 4 in the peanut-avoidance group and 0 in the peanut-consumption group no longer had allergy. Lines represent population means. The log 10 of the ratio of peanut-specific IgG4:IgE was calculated after peanut-specific IgE levels were converted from kilo unit per liter to nanograms per milliliter with the use of the formula (IgG4÷[IgE×2.4]).
n engl j med 374;15 nejm.org April 14, 2016
The New England Journal of Medicine Copyright © 2016 Massachusetts Medical Society. All rights reserved.
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